Ventral abdominal wall hernias occur in nearly one-third of the over two million patients undergoing laparotomies in the United States each year. These hernias not only affect patient quality of life through pain and discomfort, but can also cause life-threatening visceral incarceration and strangulation. An estimated 350,000 ventral hernia repairs are performed annually, involving a total cost of US $3.2 billion (2006 data). Despite advances in repair techniques and availability of a wide variety of synthetic and biological grafts, hernia repairs continue to rise in incidence and cost, with 24-43% of repairs failing to heal. Biologic grafts are recommended in hernia patients with bacterial contamination or high risk wounds, and are also preferred in laparoscopic ventral hernia repair requiring intraperitoneal placement of the graft. However, biologic grafts often lose strength and integrity after implantation, and undergo stretching, thinning and premature failure, resulting in repair bulging, dehiscence and hernia recurrence. Currently, the mechanisms for premature biological graft resorption are unknown, but likely involve a combination of patient clinical factors, surgical technique, and graft-related factors that affect cellular response and ultimately graft fate.